116例老年晚期非小细胞肺癌一线化疗或易瑞沙治疗分析  

Comparison of gefitinib and chemotherapy as first-line therapy for 116 elderly patients with advanced non small cell lung caner

作　　者：李艳莹[1] 张新星[1] 丁振宇[1] 余敏[1] 朱江[1] 周麟[1] 徐泳[1] 彭枫[1] 李潞[1] 黄媚娟[1] 

机构地区：[1]四川大学华西医院胸部肿瘤科,四川成都610041

出　　处：《现代预防医学》2012年第23期6343-6347,共5页Modern Preventive Medicine

摘　　要：目的比较晚期老年非小细胞肺癌(non-small cell lung cancer,NSCLC)患者使用单药化疗、含铂化疗和易瑞沙一线治疗的疗效和副反应。方法回顾某院从2006年5月～2009年6月收治的老年(﹥70岁)晚期非小细胞肺癌患者,纳入ECOG评分0～1分的116例患者。其中33例接受易瑞沙治疗,39例接受单药化疗,44例接受含铂双药化疗。结果在116例患者中,易瑞沙、单药化疗、含铂双药化疗的3组客观缓解率(objective response rate,ORR)分别为24.2%、5.1%和13.6%,P=0.064。易瑞沙、单药化疗、双药化疗3组的中位无疾病进展生存时间(failure-free survival,PFS)分别为4、2、3月,P=0.005。在两两比较时,易瑞沙较单药化疗及双药组均延长了中位PFS,差异有统计学意义(P=0.005,P=0.025)。易瑞沙组的总中位生存时间(overall survival,OS)为10月,单药化疗组8月,双药化疗组12月(P=0.039)。在两两比较中,仅有双药化疗比单药延长了中位OS(P=0.01)。3～4度不良反应发生率分别是易瑞沙组:4例(12.1%),单药化疗组:9例(23.1%),双药化疗组:20例(45.5%),P﹤0.001。没有治疗相关性死亡发生。结论含铂双药化疗一线治疗ECOG评分较好的老年NSCLC比单药化疗可显著延长OS,且双药化疗可以耐受。易瑞沙和双药化疗的OS差异无统计学意义,但耐受性更好。以上结果有待进行前瞻性临床试验进一步证实。OBJECTIVE To investigate the effects and safety of gefitinib, single-agent and platinum-doublet therapy for elderly patients with good ECOG score and advanced / metastatic NSCLC retrospectively. METHODS From MAY 2006 to July 2009, 116 patients were reviewed. 33 patients received gefitinib monotherapy, 39 patients received single-agent chemotherapy and 44 patients received platinum-doublet therapy. RESULTS Objective response rate in gefitinib, single-agent and platinumdoublet groups were 8 （24.2%）, 2 （5.1%） and 6 （13.6%） P=0.064. The median PFS in the gefitinib, single-agent, and platinum-doublet groups was 4,2,and 3 months, respectively （P=0.005）. The median OS was 10, 8, and 12 months, in the three groups respectively （P=0.039）. But only platinum-doublet group had longer median OS compared with single-agent （P=0.01） in pairwise comparison. Incidence of grade 3 or 4 adverse events was 4（12.1%）, 9（23.1%） and 20（45.5%） in the three groups separately （P﹤0.001）. There were no adverse events leading to death. CONCLUSION This trial reveals platinum-doublet chemotherapy provides a longer survival than single agent therapy in elderly patients with NSCLC, with acceptable toxicity. Gefitinib derives similar OS and better tolerability compared with platinum -doublet chemotherapy arms. Prospective study is needed to evidence our conclusion.

关 键 词：非小细胞肺癌 老年 化疗 吉非替尼 回顾研究 

分 类 号：R734.2[医药卫生—肿瘤]